芪参复康胶囊、氟西汀对首发抑郁症患者事件相关电位的影响

目的评价芪参复康胶囊、氟西汀对首发抑郁症患者认知功能的影响。方法将本院63例首发抑郁症患者按随机数字表法分2组，中药组（31例）给予芪参复康胶囊0．2-0．6g口服，3次／d，西药组（32例）给予用氟西汀胶囊（江苏常州制药有限公司生产）20-40（20±5）mg／d，每日晨口服，可酌情短期合用小剂量苯二氮卓类药，不合用其他抗抑郁药。两组患者于治疗前、治疗后6周进行17项HAMD评定及行P300检查，32名健康志愿者（对照组）行P300检查。分析两组患者治疗前后对认知功能的影响。结果（1）两组治疗前HAMD评分比较差异无统计学意义（29．1±5．1）分vs（29．0±4．5）分，P〉0．05]，治疗后中药组HAMD评分低于西药组（10．1±3．2）分vs（12．3±3．4）分，P〈0．05]，HAMD减分率显著高于西药组（65．6±2．1）％vs（57．9±3．2）％，P〈0．05]。（2）两组治疗前Cz点潜伏期及波幅与对照组比较差异均无统计学意义（P〉0．05）。两组治疗后较治疗前的P2、N2、P3的潜伏期均显著缩短P2（152．8±54．1）ms vs（208．9±57．6）ms，（174．5±63．2）ms vs（207．3±55．8）ms；N2（208．7±57．9）ms vs（273．4±62．0）ms，（239．2±59．2）ms vs（275．6±60．8）ms；P3（319．1±60．2）ms vs（396．3±66．3）n18，（315．6±61．1）ms vs（394．7±55．6）ms，P均〈0．05]，波幅均显著升高P2（7．8±1．7）μV vs（3．3±1．2）μV，（7．0±1．4）μV vs（3．4±1．4）μV；N2（3．6±1．4）μV vs（1．0±0．7）μV，（2．4±1，3）μV vs（1．2±1．0）μV；P3（9．6±2．2）μV vs（4．5±1．0）μV，（7．5±2．2）μV vs（4．6±1．2）μV，P均〈0．05]；治疗后，与中药组相比，西药组P2、N2的潜伏期延迟（P〈0．05），P3的潜伏期与中药组相近（P〉0．05），N2、P3的波幅偏砥（P〈0．05），P2的波幅值与中药组相近（P〉0．05）。（3）与对照组相比，治疗前中药组、西药组P2、N2、P3的潜伏期均显著延迟，波幅都显著降低（P〈0．05）；治疗后中药组P2、N2、P3的潜伏期值及P2、N2、P3的波幅值与对照组相近（P〉0．05）。西药组P2、N2的潜伏期显著延迟（P〈0．05），P3的潜伏期值与对照组相近（P〉0．05），P2、N2、P3的波幅显著偏低（P〈0．05）。结论芪参复康胶囊芪、氟西汀治疗可改善首发抑郁症认知功能，而芪参复康胶囊提高患者信息加工的前期准备效率优于西药氟西汀。

Effects of Qishen Fukang capsules and Fluoxetine treatments on event-related potentials in first-episode depressions

Abstract] Objective To compare the effects of Qishen Fukang capsules and Fluoxetine on cogni- tive function in first-episode depressions. Methods Between December 2011 and January 2012, 63 de- pressed patients with first-episode from Center for Mental Disease Control and Prevention of Third Hospital of PLA were enrolled, and were divided randomly into the Qishen Fukang capsules-treated group （ Chinese medicine group, CMG, 31 cases） and fluoxetine treated group （Western medicine group, WMG, 32 cases; Jiangsu changzhou pharmaceutical Co. , LTD production） by the method of the random number table. The therapeutic dose was oral 0.2 - 0.6 g （ three times/d） for each CMG patient, and morning oral 20 ~ 40 （20 ±5） mg/d for each WMG patient. Meanwhile, each patient was given the short -term small doses ofbenzodiazepine drugs, but no other antidepressants. Each patient and control was assessed with 17-item Hamilton Depression Scale （HAMD）. A total of 32 healthy subjects were involved as control group. Each patient was measured with evoked event-related potential P300 change before and after 6 weeks treatment. And compared the effects of Qishen Fukang capsules and Fluoxetine on cognitive function in first-episode depressions before and after treatment. Results （1） Compared with prior-treatment CMG （29. 1 ± 5. 1 ） score vs WMG（29. 0 ± 4. 5）score], the HAMD scores of post-treatment CMG（ 10. 1 ± 3.2）score vs WMG （12. 3 ± 3.4） score ] were decreased significhntly （ P 〈 0. 05 ）. The HAMD scores in CMG were signifi- candy lower than the WMG（ P 〈 0. 05）. The HAMD reductive rate in CMG was significantly higher than the WMG （65.6 ±2. 1）% vs （57.9 ±3.2）%, P 〈0. 05]. （2）Compared with prior-treatment, the laten- cy periods of post-treatment were shortened P2 （ 152. 8 ± 54. 1 ） ms vs （208.9 ± 57. 6 ） ms, （ 174. 5 ± 63.2） ms vs （207. 3 ± 55.8 ） ms; N2 （ 208. 7 ± 57. 9 ） ms vs （ 273.4 ± 62. 0） ms, （239. 2 ± 59. 2） ms vs （275.6 ±60. 8）ms; P3（319. 1 ±60. 2）ms vs （396. 3 ±66. 3）ms, （315.6 ±61.1）ms vs （394. 7 ±55.6） ms ], while the amplitudes were prolonged P2 （7. 8 ± 1.7 ） IJ, V vs （3.3 ± 1.2 ） μV, （7. 0 ± 1.4 ） μV vs （3.4 ±1. 4）μV; N2 （3.6±1.4）μV vs （1.0 ±0.7）μV, （2.4 ±1.3）μV vs （1.2 ±1. 0）μV; P3 （9.6 ±2. 2）μVvs （4.5±1.0）μV, （7.5±2.2）μV vs （4.6±1.2）μV] in the CMG and WMG （allP 〈 0.05）. Compared with the CMG, the latency periods of P2, and N2 were significantly longer （all P 〈 0. 05）, and the latency period of P3 was no difference （ P 〉 0. 05 ）, and the amplitudes of N2, and P3 were lower （ all P 〈 0. 05 ）, and the amplitude of P2 was no difference （ P 〉 0. 05 ） in the post-treatment of WMG. （3）Compared with the controls, the latency periods of P2, N2, and P3 were shortened, while the amplitudes were prolonged in the post-treatment of CMG and WMG （ all P 〈 0. 05 ）. The latency periods and amplitudes of P2, N2, and P3 did not show any difference in the CMG after treatment （ all P 〉 0.05）. The latency period of P2, and N2 were still significantly longer （ all P 〈 0.05 ） and the latency period of P3 was no difference （ P 〉 0. 05） while the amplitude of P2, N2, and P3 were still significantly lower （ all P 〈 0. 05） in the post-treatment of WMG. Conclusions Qishen Fukang capsules and Fluoxetine can im- prove significantly cognitive function in first-episode depressions. Qishen Fukang capsules is superior to flu- oxetine on improving the early preparation efficiency of information processing.